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Open Access 01-02-2021 | Liver Resection | Original Article

Prognostic evaluation of HCC patients undergoing surgical resection: an analysis of 8 different staging systems

Authors: Jan Bednarsch, Zoltan Czigany, Daniel Heise, Katharina Joechle, Tom Luedde, Lara Heij, Philipp Bruners, Tom Florian Ulmer, Ulf Peter Neumann, Sven Arke Lang

Published in: Langenbeck's Archives of Surgery | Issue 1/2021

Abstract

Purpose

No consensus exists regarding the most appropriate staging system to predict overall survival (OS) for hepatocellular carcinoma (HCC) in surgical candidates. Thus, we aimed to determine the prognostic ability of eight different staging systems in a European cohort of patients undergoing liver resection for HCC.

Methods

Patients resected for HCC between 2010 and 2019 at our institution were analyzed with Kaplan-Meier and Cox regression analyses. Likelihood ratio (LR) χ² (homogeneity), linear trend (LT) χ² (discriminatory ability), and Akaike Information Criterion (AIC, explanatory ability) were used to determine the staging system with the best overall prognostic performance.

Results

Liver resection for HCC was performed in 160 patients. Median OS was 39 months (95% confidence interval (CI): 32–46 months) and median RFS was 26 months (95% CI: 16–34 months). All staging systems (BCLC, HKLC, Okuda, CLIP, ITA.LI.CA staging and score, MESH, and GRETCH) showed significant discriminatory ability regarding OS, with ITA.LI.CA score (LR χ² 30.08, LT χ² 13.90, AIC 455.27) and CLIP (LR χ² 28.65, LT χ² 18.95, AIC 460.07) being the best performing staging systems.

Conclusions

ITA.LI.CA and CLIP are the most suitable staging system to predict OS in European HCC patients scheduled for curative-intent surgery.

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Title: Prognostic evaluation of HCC patients undergoing surgical resection: an analysis of 8 different staging systems
Authors: Jan Bednarsch
Zoltan Czigany
Daniel Heise
Katharina Joechle
Tom Luedde
Lara Heij
Philipp Bruners
Tom Florian Ulmer
Ulf Peter Neumann
Sven Arke Lang
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Liver Resection
Liver Resection
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Langenbeck's Archives of Surgery / Issue 1/2021
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-02052-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Prognostic evaluation of HCC patients undergoing surgical resection: an analysis of 8 different staging systems

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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